Provider Demographics
NPI:1265631626
Name:ACADEMY ROAD MEDICAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:ACADEMY ROAD MEDICAL ASSOCIATES, LLC
Other - Org Name:HERBERT M. SCHECTER, D.O.
Other - Org Type:Other Name
Authorized Official - Title/Position:SOLE PROPRIATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHECTER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:215-637-4300
Mailing Address - Street 1:10431 ACADEMY RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19114-1126
Mailing Address - Country:US
Mailing Address - Phone:215-637-4300
Mailing Address - Fax:215-637-8507
Practice Address - Street 1:10431 ACADEMY RD
Practice Address - Street 2:SUITE J
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1126
Practice Address - Country:US
Practice Address - Phone:215-637-4300
Practice Address - Fax:215-637-8507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-16
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001258599Medicaid
PA001258599Medicaid